Margaret Bourdeaux: Why civilians suffer more once a war is over
Margaret Bourdeaux: A béke háborús áldozatai
Margaret Bourdeaux investigates the best ways to protect, recover and reconstruct health systems and institutions disrupted by war or disaster. Full bio
Double-click the English transcript below to play the video.
what it would be like
milyen lehet olyan helyen élni,
there are no rules
and there are no laws.
és nincsenek törvények.
have disappeared.
közösségi intézmény is eltűnt.
about what this is like,
a medical student in 1999,
in the Balkans during the Kosovo War.
orvostanhallgatóként
from my medical school
az évhalasztási engedélyt
that I had befriended in the camp
amelyeket a táborban ismertem meg,
life in this postwar setting.
a háború utáni körülmények között.
was a very interesting place
the war didn't break out again.
it was actually a lawless place,
törvények nélküli hely volt.
both public and private,
– állami vagy magán –
of these situations and settings,
ilyen körülmények közé,
before you run into a situation
az ember valami olyan szituációba,
how incredibly vulnerable you are.
when I had to cross the first checkpoint,
át kellett menjek az első ellenőrzőponton,
through this checkpoint
right then and there,
anything illegal.
semmi illegálisat
was absolutely nothing
semmiség volt
of the families that I got to know
where there are no social institutions
nem működnek a közintézmények,
és bizonytalansággal,
"What are we going to eat tonight?"
mint hogy mit eszünk ma,
when you don't have any security systems,
bármi kérdés sokkoló lehet
with the neighbor down the block
az utcán, a szomszéddal
that will end my life
when there is no health system
had to sort through questions like,
hogy ilyen kérdésekkel szembesültek:
What am I going to do?"
is bleeding. What should I do?
Mit kéne tennem?
where are the nurses?
hol találok egy nővért?
In what currency will I pay them?"
where will I find them?
hol találok?
are they actually counterfeits?"
the dominant feature of life,
kiszolgáltatottság körül forog,
that people have to manage
is incredibly difficult to explain
hihetetlenül nehéz elmagyarázni,
who are living outside of it.
amikor eljöttem Koszovóból.
I became a physician,
health policy researcher.
foglalkozó kutató,
Division of Global Health-ben.
Division of Global Health.
on this problem right away.
akartam kezdeni:
the crushing vulnerability
bizonytalanságban élők
of fragile settings?
we can start to think about
that are critical to survival,
intézményeket,
I had amazing colleagues.
nagyszerű munkatársaim voltak.
question for them.
"Oh, if you work in war,
"Háborúban dolgozni
you work on refugee camps,
mass atrocities?" --
very, very important.
why I was so passionate about this issue,
hogy miért szívügyem a téma.
a feltűnést keltő munka,
the public health consequences of war
provocative conclusion.
következtetésre jutott.
and disability from war
sérülések nagy többsége
living in a conflict-affected state
a legveszélyesebb időszak az egyénnek
has been achieved.
but of course it's not,
by robbing them of their clinics,
az embereket a klinikáktól,
they're on the run.
megölték, elmenekültek.
and yet more deadly is the destruction
végzetesebb a pusztítás
and their finances.
és finanszírozásukban.
surprising at all to me.
and somewhat dismaying,
és megijesztett valamiképp,
about human suffering and war.
és a háborúról gondolkodunk.
country of Liberia.
about this group, Doctors Without Borders,
Határok Nélkül csoporttal,
and calling for aid and assistance.
és segítséget kérnek.
answered the question:
adott választ a kérdésre:
even in Liberia?
az Orvosok Határok Nélkül?
szervezet; arra és úgy vannak kialakítva,
is an amazing organization,
emergency care in war zones.
nyújtsanak sürgős esetekben.
2003-ban befejeződött,
before Ebola even struck.
kitörése előtt történt.
in the entire country
a functioning health system,
11 évvel később sincs
aid was phenomenal.
nemzetközi segély érkezett.
two percent of that funding
mindössze 2%-át fordították
Haitian public institutions,
from the earthquake even today.
in the northern autonomous region of Iraq,
Kurdisztánnak
that in the last nine months,
hogy az elmúlt 9 hónapban
from four million people
have experienced incredible trauma.
hihetetlen traumákat éltek át.
16-hour days without pay.
dolgoznak fizetség nélkül.
by 25 percent;
növekedett volna 25%-kal,
and to short-term relief efforts.
segítségnyújtásra irányították át.
szerint ez fog történni –
of the five million people in his region
whether they should flee
this is a frustrating topic for me,
and security systems?
és biztonsági rendszert?
two arguments.
érvet rakok össze.
in these settings are corrupt
ilyen körülmények között korruptak
unsavory characters
az egészségügyi ágazatban
in these situations.
is absolutely true
to Haiti, to Liberia --
Koszovótól Haitiig, Libériáig.
for their country,
to save their health institutions.
az egészségügyi rendszert.
who wants to help
in Afghanistan.
success stories
in Afghanistan
próbálkozásunknak
investing heavily
Afghani health sector leaders.
felkészítésébe és kiemelésébe.
have pulled off an incredible feat
megbecsülést vívtak ki maguknak
access to health care
hogy a népesség zöme
az egészségügyi ellátáshoz.
the health status
of Health does things
minisztérium azt teszi,
we just don't have the money.
magunknak, nincs rá pénz.
that the current situation
we could possibly conceive of.
a legkevésbé hatékony.
is that when governments like the US --
of governments
segélyezésre világszerte
and disaster relief worldwide.
vagy vészhelyzet esetén.
that's just disaster relief.
csak a katasztrófakárok enyhítése.
goes to international relief agencies,
nemzetközi segélyszervezeteknek,
into these areas,
juttassák az érintett területekre,
of temporary health system, let's say,
ideiglenes egészségügyi rendszereket,
when they run out of money.
s szélnek eresztenek, ha elfogyott a pénz.
community policy experts,
megoldások szakértői vagyunk,
in how to monitor
erősségei és gyengéi
of health systems
and wave our arms.
a vészharangot, integetnünk.
they don't need us to tell them that.
nem kell mondanunk.
need to take their cue
én is dolgozom a Harvardon,
tapasztalatai alapján
in Afghanistan,
health sector leaders like these.
vezetők támogatására.
with some support.
and make new partnerships.
és új kapcsolatokat kiépítenünk.
with NATO and other security policy makers
kezdeményezésbe fogtunk,
to protect health system institutions
az egészségügyi rendszerek védelmében
and other critical social institutions
és a szociális intézmények megóvása
collateral damage;
we need to engage is you,
akit meg kell nyerjünk, azok önök,
and indeed, the world public.
sőt, a világ nyilvánossága.
the value of social institutions,
a szociális intézmények,
in these fragile settings,
az ilyen törékeny helyzetekben,
tett erőfeszítéseket sem.
doctors are on the run in country X.
teljesítőképességére,
to, let's say, detect influenza."
That's what I'd tell you.
institution defenders and builders.
akik sokat tettek Amerika intézményeiért.
the Marshall Plan
institutions after World War II.
megmentésére a II. világháború után.
really serves as the foundation
munkája alapvetésként szolgál
human rights organizations.
szervezetünk számára.
in terms of creating institutions,
létrehozása terén,
körül is bábáskodott.
country was threatened,
amikor a hazánk veszélyben volt,
to protect human security,
az emberi biztonság védelmében,
és a miénkére is.
should do the same.
is ezt kéne tennie.
ABOUT THE SPEAKER
Margaret Bourdeaux - Physician, global health policy analystMargaret Bourdeaux investigates the best ways to protect, recover and reconstruct health systems and institutions disrupted by war or disaster.
Why you should listen
Margaret Ellis Bourdeaux, MD, MPH spearheads the Threatened Health Systems Project at Harvard Medical School -- an initiative that brings together public sector leaders, health care providers, academics, military strategists and private sector stakeholders to generate creative approaches to protecting valuable health system resources in countries affected by armed conflict and acute political crisis.
Bourdeaux's journey in global health began when she took a year of leave from Yale Medical School to work in refugee camps during the Kosovo War in 1999. She returned on her own after the war to trace families she had befriended in the camps and find out what had happened to them. Living in villages of Kosovo's countryside, she documented how these families struggled to care for their children, find health services and make a living in a society decimated by genocide and ethnic conflict. This experience impressed upon her the stark truth that war kills people by stripping them of their personal, community and national resources and institutions. Far more people died in Kosovo from the depleted health systems and institutions than from wounds sustained during the armed conflict.
Later experiences in Haiti, Afghanistan, Libya, Sierra Leon, Madagascar and Liberia revealed a similar pattern: armed conflict would decimate indigenous health institutions that never recovered, leaving people helpless when later crises -- earthquakes, epidemics, renewed conflict -- invariably struck. Strong, resilient health systems are the key to making war, disasters and epidemics less deadly.
After completing a joint residency in Internal Medicine and Pediatrics at the Harvard Combined Med/Peds Program, Bourdeaux was among the first graduates of Brigham and Women's Global Women's Health Fellowship. She has worked with the Office of the Secretary of Defense Policy to analyze the US Department of Defense’s global health projects and programs. She led a joint Harvard-NATO team of analysts to evaluate the impacts, challenges and opportunities international security forces have in protecting and rebuilding health systems in conflict affected states. She joined the faculty of the Division of Global Health Equity at Brigham and Women’s Hospital and Harvard Medical School in 2011.
This year she was awarded the prestigious Harvard Global Health Institute's Burke Fellowship in Global Health to investigate the responsiveness of foreign aid to health system distress and disruption. She is co-developing the first executive education course between Harvard Medical School and Harvard Kennedy School of Government for senior security policy makers on health system threat detection and response. In addition, she is launching Harvard Global Health Institute's first Summit on Threatened Health Systems in June 2017.
Margaret Bourdeaux | Speaker | TED.com